The circumferential resection margin included the anterior and posterior surfaces of all pancreatic resections and the common bile duct margin, uncinate process margin, superior mesenteric artery surface, and superior mesenteric vein surface for pancreaticoduodenectomy. Surgery remains the mainstay treatment.
Keywords: pancreatic cancer; resection margin; R1; definition of resection status; pathological standardization 1.
; >10 years of clinical experience for all).
Background: The definitions for R0 and R1 margin status after resection for pancreatic cancer are controversial. Wolters Kluwer Negative resection margin (R0) rates were assessed based on CT resectability status in patients who underwent upfront surgery.
Second, when compared with the radiology reporting template for pancreatic cancer proposed by the Society of Abdominal Radiology and the American Pancreatic Association (In conclusion, CT resectability is used to stratify patients with pancreatic cancer according to the possibility of R0 resection. The resectable status at CT enabled prediction of R0 resection with a positive predictive value of 73%.
Epub 2020 Jan 17. Larger tumor size and tumor abutment to the portomesenteric vein are associated with margin-positive resection in patients with resectable pancreatic cancer.CT resectability is used to stratify patients with pancreatic cancer according to the possibility of complete R0 resection; the resectable status, as determined at CT, enabled prediction of complete resection, with a positive predictive value of 73%.■ CT resectability of pancreatic cancer, determined according to National Comprehensive Cancer Network criteria, is useful when assessing the possibility of complete margin-negative resection in patients with pancreatic cancer.■ Tumor diameter and tumor abutment to the portomesenteric vein on CT images may be used to select patients with a higher possibility of margin-negative resection from among patients with resectable pancreatic cancer at CT.Pancreatic cancer is an aggressive abdominal malignancy, with an overall 6.8%–7% 5-year survival rate (Pancreatic cancer resectability is determined primarily by the degree of tumor–vascular contact, as assessed on CT or MR images obtained with a pancreas protocol (Thus, in this retrospective cohort study, we evaluated patients with pancreatic cancer who underwent upfront surgery at one high-volume institution where extended pancreatic resection is commonly performed. *Major vascular invasion was evaluated for the portal vein; superior mesenteric vein; inferior vena cava; first jejunal vein; aorta; celiac axis; common, proper, right, and left hepatic arteries; superior mesenteric artery; first jejunal artery; and aberrant hepatic arteries and was defined as no contact (no tumor vascular contact), abutment (tumor–vascular contact ≤180°), encasement (tumor–vascular contact >180° or vascular deformity), occlusion, or tumor thrombosis.Two board-certified abdominal radiologists (S.B.H., S.S.L. 2020 May 29;21(11):3890. doi: 10.3390/ijms21113890.Front Oncol.
Larger tumor size and tumor abutment to the portomesenteric vein are associated with margin-positive resection in patients with resectable pancreatic cancer.The authors thank Kyu-pyo Kim, Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, for the advice on oncologist management of pancreatic cancer.Supported by Basic Science Research Program through the National Research Foundation of Korea and the Ministry of Science ICT and Future Planning (NRF-2017R1A2B4003114).
Please enable it to take advantage of the complete set of features! Pathologic examination was performed on serial sections of the entire pancreas specimen.
Furthermore, patients who undergo curative intent resection have high risk of recurrence, particularly those with microscopic residual tumor at the resection margins (3–5).
The structured report was intended to facilitate use by radiologists and include all necessary information for pancreatic cancer staging according to NCCN guidelines, version 1.2017 (Note.—CHA = common hepatic artery, GDA = gastroduodenal artery, IVC = inferior vena cava, NCCN = National Comprehensive Cancer Network, PV = portal vein, SMA = superior mesenteric artery, SMV = superior mesenteric vein.
Importantly, this effect held true only for pancreatic head resection both in the meta-analysis [R0 ≥0 mm: HR 1.21 (1.05-1.39) vs R0 ≥1 mm: HR 1.66 (1.46-1.89)] and in our cohort (R0 ≥0 mm: 31.8 vs 14.5 months, P < 0.001; R0 ≥1 mm, 41.2 vs 16.8 months; P < 0.001). For the primary outcome, R0 resection was defined as complete tumor resection with a negative resection margin. For tumors of the pancreatic body and head, resectability can be estimated when the pancreas is transected above the portal/superior mesenteric vein, but at this stage the resection has to be completed even if an R0 resection …
Although surgical resection is the only potentially curative technique for managing pancreatic cancer, only 15% to 20% of patients are eligible for this procedure.
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